Karim M Soliman1,2, Christopher Molini3, Tessa Novick4, Steven Menez4, Tibor Fülöp1,5, Edward Kraus6, Blaithin A McMahon7. 1. Division of Nephrology, Department of Medicine, Medical University South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA. 2. Department of Medicine, Division of Nephrology, Cairo University, Cairo, Egypt. 3. Nephrology Associates, Church Street, Nashville, TN, USA. 4. Dell Medical School, University of Texas, Austin, TX, USA. 5. Ralph H. Johnson VA Medical Center, Charleston, SC, USA. 6. Comprehensive Renal Transplantation Unit, Johns Hopkins University School of Medicine, Baltimore, USA. 7. Division of Nephrology, Department of Medicine, Medical University South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA. mcmahonb@gmail.com.
Abstract
BACKGROUND: Acceptance of organs from acute chemical intoxicated donors remains controversial and outcomes are insufficiently explored. METHODS: This is a single-center retrospective cohort analysis of 484 patients undergoing deceased donor kidney transplantation (DDKT). We assessed the association of positive urine drug screen before transplantation with cohort statistics, delayed graft function (DGF), and graft outcomes at 2 years. Multiple logistical regression (MLR) analysis was used to assess the odds ratio for DGF. RESULTS: Of 484 random DDKTs performed at our institution between January 2010 and October 2015, 280 deceased kidney donors were current drug users. Mean age was 35.4 (15) years, 39% male, 61% were African Americans, and 38.2% had more than one test positive. The main chemical toxins detectable in donor urine were alcohol, heroin, opioid/methadone, cocaine, marijuana, benzodiazepines, methamphetamine, ecstasy, and LSD. Single and multiple urine chemical toxicology of kidney donors did not have a significant effect on KT outcomes of DGF and graft failure during a median follow-up (P for odds ratios > 0.05). CONCLUSIONS: The use of deceased donor kidney grafts from donors with positive urine chemical toxicology may be a worthwhile method of increasing the availability of scarce donor kidney organs as such exposure to illicit drug(s) is not associated with major adverse transplant outcomes.
BACKGROUND: Acceptance of organs from acute chemical intoxicated donors remains controversial and outcomes are insufficiently explored. METHODS: This is a single-center retrospective cohort analysis of 484 patients undergoing deceased donor kidney transplantation (DDKT). We assessed the association of positive urine drug screen before transplantation with cohort statistics, delayed graft function (DGF), and graft outcomes at 2 years. Multiple logistical regression (MLR) analysis was used to assess the odds ratio for DGF. RESULTS: Of 484 random DDKTs performed at our institution between January 2010 and October 2015, 280 deceased kidney donors were current drug users. Mean age was 35.4 (15) years, 39% male, 61% were African Americans, and 38.2% had more than one test positive. The main chemical toxins detectable in donor urine were alcohol, heroin, opioid/methadone, cocaine, marijuana, benzodiazepines, methamphetamine, ecstasy, and LSD. Single and multiple urine chemical toxicology of kidney donors did not have a significant effect on KT outcomes of DGF and graft failure during a median follow-up (P for odds ratios > 0.05). CONCLUSIONS: The use of deceased donor kidney grafts from donors with positive urine chemical toxicology may be a worthwhile method of increasing the availability of scarce donor kidney organs as such exposure to illicit drug(s) is not associated with major adverse transplant outcomes.
Entities:
Keywords:
Donor; Drugs of abuse; Outcomes; Renal transplantation; Toxicology; Urine drug